Jackson, Mark R

Jackson, Mark R is an individual health care provider with primary practice located at 3 Saint Francis Dr Suite 330, Greenville SC 29601-3971. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Jackson, Mark R can be contacted via phone (864) 255-1834.

Contact Information

Primary practice address
3 Saint Francis Dr Suite 330 Greenville SC 29601-3971
Phone: (864) 255-1834
Fax: (864) 255-1836
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 23559 South Carolina
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 23559 South Carolina

Profile Details

NPI number 1033177530
LBN Legal business name Jackson, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Nov 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033177530 NPPES
North Carolina MEDICAID 89067KH
North Carolina MEDICAID T78966

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